ABSITE Review - Cardiac Flashcards
Which type of shunt from congenital heart disease cause cyanosis? What maneuvers help?
R to L shunts
Squats - increase SVRI and decreases the shunt
What is Eisenmenger’s syndrome?
Shift from L –> R shunt to R –> L
What is the end result of L –> R shunt?
CHF
What is the first sign of CHF in children?
Hepatomegaly
What are the congenital conditions that cause L –> R shunt?
VSD, ASD, PDA
What are the congenital conditions that cause R –> L shunt?
Tetralogy of Fallot, Transposition of the great vessels, truncus arteriosus
What is the ductus arteriosus?
Connection between descending aorta and left pulmonary artery; blood shunted away from lungs in utero.
What is the ductus venosum?
Connection between portal vein and IVC; blood shunted away from liver.
How many umbilical arteries and veins are present in fetal circulation?
2 umbilical arteries and 1 umbilical vein
What is the MC congenital heart defect?
VSD
What is the treatment for VSD?
Most close spontaneously by age 6 months
MC reason for repair - CHF resulting in FTT
PVR > 4-6 woods units also indication for repair
PVR > 10-12 contraindication for repair –> use vasodilators
What is the MC type of ASD?
Ostium secundum
What is the Tetralogy of Fallot?
VSD, pulmonic stenosis, overriding aorta, RVH
What is the surgical treatment for Tetralogy of Fallot?
Blalock-Taussig shunt for palliation to delay repair
RV outflow tract obstruction division, patch enlargement of outflow tract and VSD repair
What can be used to close a PDA?
Indomethacin
What can be used to keep open a PDA?
PGE1
Where is the MC location for coarctation of the aorta?
Usually occurs just distal to the L subclavian artery
What syndrome is associated with CoA?
Turner’s Syndrome
What is a CXR finding seen in CoA?
Rib notching from the IMA and intercostal collaterals
What is the treatment for hypoplastic left heart?
Norwood procedure
What is the MC heart dominant circulation?
Right dominant - MC - posterior descending artery comes off the RCA
What are some complications of MI?
VSD (pansystolic murmur), papillary muscle rupture, and free wall rupture. Most likely to occur at 3-7 days post-MI.
What is the best conduit for CABG?
Internal mammary artery - >90% 10-year graft patency rate
What is the MC valve lesion?
Aortic stenosis
What is the MCC of valve dysfunction?
Rheumatic heart disease - Mitral most commonly involved valve
What are the indications to operate on a stenotic valve?
When symptomatic or valve area < 1cm2
What is the MC site for prosthetic valve infection?
Aortic valve
What is the MC site for native valve infection?
Mitral valve
What is the MC organism resposible of endocarditis?
S. Aureus
What are the indication for surgery in endocarditis?
Failure of antimicrobial therapy, valve failure, perivalvular abscesses, pericarditis
Which patients need periprocedural endocarditis prophylaxis?
Prosthetic valves, rheumatic heart disease, congenital cardiac malformations, MVP with MR, previous hx of bacterial endocarditis
What is the MC benign tumor of the heart?
Myxoma - 75% in LA
What is the MC malignant tumor of the heart?
Angiosarcoma
What is the MC metastatic tumor of the heart?
Lung CA
What tissue in the body has the lowest oxygen tension?
Coronary veins due to high oxygen extraction by myocardium
What is the postpericardiotomy syndrome? What is the treatment?
Pericardial friction rub, fever, chest pain, SOB
Tx - NSAIDs, steroids
What is the first sign of cardiac tamponade in ECHO?
decrease right atrial diastolic filling
